East Devon community bed closures to be speeded up – Seaton to close next week, Honiton the week after

From the blog of Claire Wright – did Diviani and Randall-Johnson know this? Do they care?

“I have seen this SO many times.

A threat to hospital beds. Hospital beds close temporarily due to staffing shortages (because understandably staff leave) and then the permanent closures are brought forward.

What I am not reassured on here is how the loss of the existing beds will morph into the new care at home service and the message on staff redeployment is as vague as ever. Last autumn, I was told by the CCG chair, Tim Burke that around double the number of staff will be appointed… the CCG now talks in terms of ‘redeployment’ and ‘recruitment’ of 50 staff, which is difficult to get to the bottom of, given what we have already been told.

What we also still don’t know (because the CCG won’t tell us) is what happens to those hospitals that lose their beds…

Devon County Council’s health scrutiny committee needs to keep a very close eye indeed, on this issue.

The letter below has been sent to Health Scrutiny committee members:

Your Future Care

I am writing to let you know that we are ready to proceed with the changes to improve care for people across Eastern Devon as part ‘Your Future Care’.

These changes are intended to shift the focus of health and care services to keep more people well and independent at home. Part of this shift will be the redeployment and recruitment of over 50 nursing, therapy and support worker roles to enhance the existing community services in each local area. This will enable the reduction in the number of community inpatient beds across the Eastern locality of Devon.

In order to achieve this safely, we will take a phased approach – working closely with staff and partners – to implement the changes as per the following timetable:

The provision of inpatient services at these locations will cease from these dates. All other services at these hospitals will continue as normal. Patients in these areas in medical need of a community inpatient bed will be accommodated at either Tiverton, Sidmouth or Exmouth hospitals, depending on where they live.

It has become apparent over the last couple of weeks that the schedule for the closure of the in-patient beds at Seaton, Okehampton and Honiton would need to be brought forward by a number of weeks due to the increasing pressures on safely staffing the current configuration of seven community inpatient units.

We have been preparing the comprehensive plans for each area since March 2017 and are confident that moving to the new model swiftly is in the best interests for our patients and our staff. For example, our new Community Connect out-of-hospital service, introduced this Spring, has already led to a reduction in demand for community inpatient beds.

Gateway Assurance Process

As you may be aware, part of the implementation process included a clinical assurance panel reviewing the implementation plans against a series of 30 gateway questions. These were developed to provide assurance of the RD&E’s and the wider system’s readiness to switch to the Your Future Care model.

The Gateway Assurance Panel has given its recommendation to proceed. The workforce HR consultation has been completed and staff have been informed of their new roles and working environments. We have also received the approval of the Equality and Quality Impact Assessments, which took place on the 4th August. We can now commence the redeployment of staff into our enhanced community teams and into the remaining community hospital sites. This change will provide extra capacity and resilience to meet the needs of our local population.

Your Future Care is just the beginning of the work needed to move fully to a model of care which proactively averts health crises and promotes independence and wellbeing for our population.

There is still much more to be done and we at the RD&E look forward to continuing this in partnership with you and our local communities.

2 thoughts on “East Devon community bed closures to be speeded up – Seaton to close next week, Honiton the week after”

We have very recently known of 3 people who have for some reason gone into hospital ( Alzheimers-definitely in
two cases but not near end of life at all) – nothing serious physically and all three families have been subjected to conversations regarding the new TEP (Treatment Escalation Plan) which replaces the DNR ( do not resuscitate); families have been asked in a most over eager, contrived, insensitive manner ( brutal) was how one described it) not part of a conversation and certainly not complying with the ‘surprise question’ ( see the guidance on TEPs online) families very upset and shocked. It was almost as if they were pushing you to it sign them up. Is this part of the new ‘Your Future Care’? a way
to rid themselves of many elderly patients. Don’t wish to alarm anyone, but feel we need to keep an eye on this.

I cannot see how they can be ready for “hospital at at home” nor how they could even have completed a robust gateway review in the timescales since the decision to proceed was made a handful of months ago.

During the consultation, we were assured that there would be a carefully planned phased approach which would not even be started until there was solid proof that patient safety would not be put at risk – but what they have announced is nothing like this.

As a professional programme / project manager in a prior career, with many years experience in the public sector, including experience with NHS programmes, it seems to me that a programme / project of this size cannot even have been planned properly in the timescales, much less that the preparatory phases have been undertaken.

My experience with the NHS was that projects were understandably paranoid about getting it wrong and people dying as a consequence. This seems to me to be so rushed that such concerns cannot possibly have been considered, much less addressed.

If they get this wrong people are going to die – and in numbers that don’t bear thinking about. Jeremy Hunt has already admitted that there are c. 8,000 avoidable deaths in England per year in hospitals due to the crisis – and that doesn’t include any other parts of the NHS like shortage of ambulances or people dying whilst ambulances queue for overstretched A&E departments etc. If what is happening here is duplicated across England, and if it is not done properly, we could easily be seeing 10x or even 100x this number of deaths.

At this stage it seems to me that it is impossible to reverse these decisions. So what we most need is a solid independent means of gathering factual evidence of whether the changes are being successful or not, and to encourage patients and relatives to report their experiences. This process needs to be independent of the NHS and especially independent of the CCG, as the way they are implementing this seems to be resulting in an absolute loss of trust.

Finally, I would like to express my utter contempt for Devon County Council, and in particular to the saboteurs of the Health Scrutiny Committee, who have utterly failed to fulfil their role to safeguard health services in Devon and to scrutinise what the CCG is doing.